home *** CD-ROM | disk | FTP | other *** search
/ Current Shareware 1994 January / SHAR194.ISO / finance / mlrcrg25.zip / REGISTER.TXT < prev    next >
Text File  |  1993-06-20  |  3KB  |  60 lines

  1.                                My Little Realm Order Form
  2.           
  3.           Name 
  4.           Last: ___________________________  First: ________________  M.I. ___
  5.                    
  6.           Address: ___________________________________________________________
  7.  
  8.           City: _________________________________________  State: ____________
  9.  
  10.           Zip: ________________ Home Phone: (________) _______________________
  11.  
  12.           * Note:  All programs must be sent to the above address.
  13.           ____________________________________________________________________
  14.           Name of the owner of the bonus program, if different from above.
  15.           
  16.           Last: ___________________________  First: ________________  M.I. ___
  17.           ____________________________________________________________________
  18.  
  19.           ____  Yes!  Please rush me the programs I've selected below.
  20.  
  21.                 Stand-alone Programs           Qty    Price         Total
  22.              
  23.                   Calling Cards               _____    $20        _________
  24.                   Charge Card                 _____    $20        _________
  25.                   Checking                    _____    $20        _________
  26.                   Private Library             _____    $20        _________
  27.                   Public Library              _____    $20        _________
  28.                   Read More                   _____    $20        _________
  29.                   Records of the Realm        _____    $20        _________
  30.                   Savings                     _____    $20        _________
  31.           ____________________________________________________________________
  32.           
  33.           ____  I'd rather save $100!  Please rush me the entire My Little 
  34.                 Realm system for only $60.
  35.                                          
  36.           My Little Realm/The System   _______   at  $60/system   _________
  37.           ____________________________________________________________________
  38.              
  39.                                               Shipping/Handling   __$5.00__
  40.              
  41.                                                        Subtotal   _________
  42.            
  43.                    New Jersey residents please add 6% sales tax   _________
  44.              
  45.                                        Total amount of purchase   _________
  46.           ____________________________________________________________________
  47.           
  48.           Disk size:   _____   5 1/4"   _____   3 1/2"    (Disks are DS/DD)
  49.           ____________________________________________________________________
  50.           
  51.           Please send your check or money order to:  
  52.                               
  53.                               John L. Salisbury 
  54.                               22 Church Street #103, Suite 376
  55.                               Ramsey, New Jersey 07446
  56.  
  57.           Checks and money orders must be drawn on U.S. banks in U.S. funds.
  58.           Sorry, phone orders cannot be accepted.  Prices subject to change.
  59.           ____________________________________________________________________
  60.